May 23, 2014 5:26 PM

I am new to running and currently on week 5 day 1 of c25k. I am experiencing pain on the inside of my left knee at or slightly below the kneecap. There is no swelling but is sensitive to the touch for about a day after and hurts a bit when I walk for the 2nd day before I run again. I have scoliosis (not severe) and am not sure if it's connected but I suspect it is. My left left leg appears longer than my right because my pelvis is pulled up on the right side. I walk with a very slight limp that is not noticeable. When I run it is noticable. I was an athletic active kid, played soccer for years and don't remember limping down the road. I'm 41 now 5' 10" 208 lbs and losing weight. Is this pain common to new runners or will it likely worsen. I try to concentrate on form but that goes quick as I'm new. Any thoughts would be appreciated

The knee injury might be related to the scoliosis...or might not. A functional leg length discrepancy (where both legs are actually the same length, but there is a structural or muscular asymmetry that causes them to appear unequal) can increase injury risk. There are a number of articles on the Web addressing this; google "functional length leg discrepancy", for example http://www.podiatrytoday.com/article/1035 Assorted symptoms can affect both legs but usually appear first on the short leg side. But a lot depends on whether your body has adjusted to the asymmetry over the years and has learned to compensate for it. You can try putting a small heel lift in your shoe on the short leg side and see if it makes a difference. If it helps, keep using it, But if the heel lift makes no difference (or if it makes things worse) then the injury is likely not related to the scoliosis.

CRL8686 is wise to point out the possible link between leg length issues and scoliosis, although there can be other causes, including neurological.

Being active for years as a soccer player may increase the likelihood of a functional leg-length discrepancy by shortening the hip flexors used when kicking. This likelihood would increase if your tendency was to kick with one particular leg, and this is now the "short" leg.

If it turns out that shortened hip flexors are responsible for drawing the pelvis & femur together on one side, the likelihood of resolving the scoliosis through physical therapy also increases. Therapy might include strengthening of the (comparatively) "weaker" hip, if it is indeed undertrained, but the goal would be to balance forces acting on the spine rather than simply increase pressure on both sides. A lot of neuromuscular re-education is necessary. In my neck of the woods, trigger-point therapy to release the shortened hip flexors would also factor in, but it must be done by people who are really good at it. Knowledge is not enough, and it takes skill to release large powerful muscles that are buried beneath the viscera of a 208 pound person. You would probably be instructed to lie on the "long" side for gravity to pull the bowels out of the way, while therapy is focused close to the spine on the "short" side. It can be done, but it ain't easy.

I want to encourage a sense of urgency, however, because the longer unequal pressure on the spine exists, the more likely it is that posture and function will be harder to reverse, and that bone will eventually conform to the stresses placed on it, which will be an entirely new problem to deal with.

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